High-risk population of progressive hepatic fibrosis in chronic hepatitis B patients on antiviral therapy.

BACKGROUND: Progressive hepatic fibrosis leads to hepatocellular carcinoma (HCC) and decompensated cirrhosis. The aim of this study was to identify the high-risk population for progressive hepatic fibrosis and the incidence of HCC and decompensated cirrhosis in chronic hepatitis B (CHB) patients with antiviral therapy. METHODS: The data came from a multicenter, center-randomized, double-blind clinical trial that analyzed only patients in the ETV-treated arm. There was 156 hepatitis B e antigen (HBeAg)-positive and 135 HBeAg-negative patients in 14 institutions. The primary endpoint was fibrosis reversal on 72-week Entecavir (ETV) treatment. The 7-year cumulative incidence of HCC and decompensated cirrhosis were analyzed. Multivariate logistic and LASSO regression analyses were used to screen variables associated with fibrosis reversal. RESULTS: 86/156 (55%) HBeAg-positive and 58/135 (43%) HBeAg-negative patients achieved fibrosis reversal on 72-week ETV treatment. Average age was 43 years, 203 (69.8%) was male, and 144 (49.5%) patients had cirrhosis. Age ≥ 40 years (OR: 0.46, 95% CI 0.23-0.93) and HBcrAg ≥ 8.23 log U/ml (OR: 2.72, 95% CI 1.33-5.54) in HBeAg-positive patients and HBV genotype C (OR: 0.44, 95% CI 0.21-0.97) in HBeAg-negative patients were independent factors of fibrosis reversal. It was confirmed in patients with cirrhosis. After 7-year ETV treatment, seven (4.5%) HBeAg-positive patients occurred HCC or decompensated cirrhosis, including four patients with age ≥ 40 years and six with HBcrAg 8.23log U/ml, while twelve (8.9%) HBeAg-negative patients occurred, including eleven with HBV genotype C. CONCLUSIONS: HBeAg-positive patients with a low HBcrAg level or old age, and HBeAg-negative patients with HBV genotype C tended to develop progressive hepatic fibrosis and had a high incidence of HCC and decompensated cirrhosis, even on ETV treatment.

Denoising Generalization Performance of Channel Estimation in Multipath Time-Varying OFDM Systems.

Although Orthogonal Frequency Division Multiplexing (OFDM) technology is still the key transmission waveform technology in 5G, traditional channel estimation algorithms are no longer sufficient for the high-speed multipath time-varying channels faced by both existing 5G and future 6G. In addition, the existing Deep Learning (DL) based OFDM channel estimators are only applicable to Signal-to-Noise Ratios (SNRs) in a small range, and the estimation performance of the existing algorithms is greatly limited when the channel model or the mobile speed at the receiver does not match. To solve this problem, this paper proposes a novel network model NDR-Net that can be used for channel estimation under unknown noise levels. NDR-Net consists of a Noise Level Estimate subnet (NLE), a Denoising Convolutional Neural Network subnet (DnCNN), and a Residual Learning cascade. Firstly, a rough channel estimation matrix value is obtained using the conventional channel estimation algorithm. Then it is modeled as an image and input to the NLE subnet for noise level estimation to obtain the noise interval. Then it is input to the DnCNN subnet together with the initial noisy channel image for noise reduction to obtain the pure noisy image. Finally, the residual learning is added to obtain the noiseless channel image. The simulation results show that NDR-Net can obtain better estimation results than traditional channel estimation, and it can be well adapted when the SNR, channel model, and movement speed do not match, which indicates its superior engineering practicability.

The Effectiveness of Intermittent Theta Burst Stimulation for Stroke Patients With Upper Limb Impairments: A Systematic Review and Meta-Analysis.

Background: Upper limb impairments are one of the most common health problems of stroke, affecting both motor function and independence in daily life. It has been demonstrated that intermittent theta burst stimulation (iTBS) increases brain excitability and improves upper limb function. Our study sought to determine the role of iTBS in stroke recovery. Objective: The purpose of this study was to determine the efficacy of iTBS in individuals with upper limb impairments following stroke. Methods: The databases used included Cumulative Index to PubMed, EMBASE, ESCBOhost, The Cochrane Library, Chinese Biomedical Database, Web of Science, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Technology Periodical Database (VIP), and WanFang Database. Studies published before November 2021 were included. Each participant received an iTBS-based intervention aimed at improving activity levels or impairment, which was compared to usual care, a sham intervention, or another intervention. The primary outcome measure was a change in upper limb function assessment. Secondary outcomes included impairment, participation, and quality of life measures. Result: A total of 18 studies (n = 401 participants) that met the inclusion criteria were included in this study. There was a slight change in the upper limb function of the iTBS group compared with the control group, as measured by the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score (mean difference 2.70, 95% CI -0.02 to 5.42, p = 0.05). Significant improvement in resting motor threshold (RMT) and motor-evoked potential (MEP) was also observed in the meta-analysis of iTBS (MD 3.46, 95% CI 2.63 to 4.28, p < 0.00001); (MD 1.34, 95% CI 1.17 to 1.51, P < 0.00001). In addition, we got similar results when the studies were using the Modified Barthel Index (MBI) assessment (mean difference of 7.34, 95% CI 0.47 to 14.21, p = 0.04). Conclusion: Our study established the efficacy of iTBS in improving motor cortical plasticity, motor function, and daily functioning in stroke patients. However, the review requires evidence from additional randomized controlled trials and high-quality research. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/.

Well-controlled gestational diabetes mellitus without pharmacologic therapy decelerates weight gain in infancy.

Aim: There are no prospective longitudinal studies on the association between well-controlled gestational diabetes mellitus (GDM) without pharmacologic therapy and the physical growth of offspring in infancy. We aimed to identify the trajectories in physical growth (from 0-12 months of age) in the offspring of mothers with well-controlled GDM without pharmacologic therapy in a prospective cohort in China. Methods: This study included 236 offspring of mothers with GDM and 369 offspring of mothers without GDM. Mothers with GDM were not on pharmacologic therapy. The length and weight of infants were measured at 0, 1, 3, 6, and 12 months. Linear mixed-effect models and linear mixed-effect models were applied. Results: The fully adjusted model showed that the weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and BMI-for-age z-score (BMIZ) were similar at birth for the GDM and control groups. However, subsequent increases in WAZ and BMIZ for the GDM group lagged the increases for the control group at the subsequent periods of observation, 0-1, 0-6, and 0-12 months. Conclusions: Well-controlled GDM without pharmacologic therapy may normalize physical growth of offspring at birth and decelerate their weight gain in infancy. Whether glycemic control can mitigate the long-term effects of GDM on the growth trajectory in offspring remains unclear.

Associations between gestational diabetes mellitus and the neurodevelopment of offspring from 1 month to 72 months: study protocol for a cohort study.

INTRODUCTION: Gestational diabetes mellitus (GDM) is a common gestational disease and an important global public health problem. GDM may affect the short-term and long-term health of offspring, but the associations between GDM and the neurodevelopment of offspring of mothers with GDM (OGDM) are still unclear, and studies based on the Chinese population are lacking. We aim to determine the associations between GDM and the neurodevelopment of OGDM by studying a cohort of OGDM and offspring of non-GDM mothers. METHODS AND ANALYSIS: The single-centre prospective cohort study is being conducted in China over 7 years. A total of 490 OGDM (GDM group) and 490 fromof healthy mothers (control group) will be enrolled during the same period. Baseline characteristics, neuropsychological development scores and clinical data at specific time points (at 0, 1, 3, 6, 12, 24, 36, 48, 60 and 72 months old) will be collected from the children in both groups until the age of 6 years. The associations between GDM and the neurodevelopment of OGDM from infancy to preschool age will be analysed using a multiple linear regression model adjusted for confounders. In addition, we will compare longitudinal data to further assess the effects of GDM on neurodevelopmental trajectories. ETHICS AND DISSEMINATION: The study has been approved by the Ethics Committee of the Children's Hospital of Chongqing Medical University (Approval Number: (2019) Institutional Review Board (IRB) (STUDY) No. 85). The findings of this study will be disseminated through open access journals, peer-reviewed journals and scientific meetings. TRIAL REGISTRATION NUMBER: NCT03997396.

Removal of silver nanoparticles by mussel-inspired Fe3O4@ polydopamine core-shell microspheres and its use as efficient catalyst for methylene blue reduction.

The removal of silver nanoparticles (AgNPs) from water is highly needed because of their increasing use and potential risk to the environment due to their toxic effects. Catalysis over AgNPs has received significant attention because of their highly catalytic performance. However, their use in practical applications is limited due to high cost and limited resources. Here, we present for the first time that the mussel-inspired Fe3O4@polydopamine (Fe3O4@PDA) nanocomposite can be used for efficient removal and recovery of AgNPs. Adsorption of AgNPs over Fe3O4@PDA was confirmed by TEM, FT-IR, XRD, TGA and magnetic property. The adsorption efficiency of AgNPs by Fe3O4@PDA was investigated as a function of pH, contact time, ionic strength and concentration of AgNPs. The kinetic data were well fitted to a pseudo-second order kinetic model. The isotherm data were well described by Langmuir model with a maximum adsorption capacity of 169.5 mg/g, which was higher than those by other adsorbents. Notably, the obtained AgNPs-Fe3O4@PDA exhibited highly catalytic activity for methylene blue reduction by NaBH4 with a rate constant of 1.44 × 10-3/s, which was much higher than those by other AgNPs catalysts. The AgNPs-Fe3O4@PDA promised good recyclability for at least 8 cycles and acid resistant with good stability.

Flat and low dispersion in highly nonlinear slot waveguides.

We propose highly nonlinear slot waveguides with flat and low dispersion over a wide wavelength range. Si nano-crystal and chalcogenide glass are considered as slot materials. Over a 244-nm bandwidth, dispersion of 0+/-0.16 ps/(nmxm) is achieved in a silicon nano-crystal slot waveguide, with a nonlinear coefficient of 2874 /(Wm). The As(2)S(3) slot waveguide exhibits dispersion of 0+/-0.17 ps/(nmxm) over a bandwidth of 249 nm, with a nonlinear coefficient 16 times larger than that of As(2)S(3) rib waveguides and a nonlinear figure of merit three times larger than that of Si strip waveguides.

Light guiding in a slot waveguide that includes an additional confining core region.

We present a design of a slot waveguide in which the core layer is orthogonally slotted to form a rectangular sub-core. While the overall guiding and coupling efficiency remains the same as a conventional slot waveguide, the field confinement is enhanced and appears two-dimensional. The waveguiding is controllable by selecting the intermediate index as well as various geometrical parameters. In addition, by changing different variables, the linear/nonlinear dispersion and birefringence can be tailored with extended ranges. Constant-dispersion points, where the dispersion is insensitive to size changes, are also demonstrated.

Highly dispersive slot waveguides.

We propose a slot-waveguide with high dispersion, in which a slot waveguide is coupled to a strip waveguide. A negative dispersion of up to -181520 ps/nm/km is obtained due to a strong interaction of the slot and strip modes. A flat and large dispersion is achievable by cascading the dispersive slot-waveguides with varied waveguide thickness or width for dispersion compensation and signal processing applications. We show - 31300 ps/nm/km dispersion over 147-nm bandwidth with <1% variance.